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首页> 美国卫生研究院文献>British Medical Journal >Household ownership and use of insecticide treated nets among target groups after implementation of a national voucher programme in the United Republic of Tanzania: plausibility study using three annual cross sectional household surveys
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Household ownership and use of insecticide treated nets among target groups after implementation of a national voucher programme in the United Republic of Tanzania: plausibility study using three annual cross sectional household surveys

机译：坦桑尼亚联合共和国实施国家优惠券计划后目标群体中的家庭拥有权和使用经过杀虫剂处理的蚊帐：使用三项年度横断面家庭调查进行的合理性研究

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>Objectives To evaluate the impact of the Tanzania National Voucher Scheme on the coverage and equitable distribution of insecticide treated nets, used to prevent malaria, to pregnant women and their infants.>Design Plausibility study using three nationally representative cross sectional household and health facility surveys, timed to take place early, mid-way, and at the end of the roll out of the national programme.>Setting The Tanzania National Voucher Scheme was implemented in antenatal services, and phased in on a district by district basis from October 2004 covering all of mainland Tanzania in May 2006.>Participants 6115, 6260, and 6198 households (in 2005, 2006, and 2007, respectively) in a representative sample of 21 districts (out of a total of 113).>Interventions A voucher worth $2.45 (£1.47, €1.74) to be used as part payment for the purchase of a net from a local shop was given to every pregnant woman attending antenatal services.>Main outcome measures Insecticide treated net coverage was measured as household ownership of at least one net and use of a net the night before the survey. Socioeconomic distribution of nets was examined using an asset based index.>Results Steady increases in net coverage indicators were observed over the three year study period. Between 2005 and 2007, household ownership of at least one net (untreated or insecticide treated) increased from 44% (2686/6115) to 65% (4006/6198; P<0.001), and ownership of at least one insecticide treated net doubled from 18% (1062/5961) to 36% (2229/6198) in the same period (P<0.001). Among infants under 1 year of age, use of any net increased from 33% (388/1180) to 56% (707/1272; P<0.001) and use of an insecticide treated net increased from 16% (188/1180) to 34% (436/1272; P<0.001). After adjusting for potential confounders, household ownership was positively associated with time since programme launch, although this association did not reach statistical significance (P=0.09). Each extra year of programme operation was associated with a 9 percentage point increase in household insecticide treated net ownership (95% confidence interval −1.6 to 20). In 2005, only 7% (78/1115) of nets in households with a child under 1 year of age had been purchased with a voucher; this value increased to 50% (608/1211) in 2007 (P<0.001). In 2007, infants under 1 year in the least poor quintile were more than three times more likely to have used an insecticide treated net than infants in the poorest quintile (54% v 16%; P<0.001).>Conclusions The Tanzania National Voucher Scheme was associated with impressive increases in the coverage of insecticide treated nets over a two year period. Gaps in coverage remain, however, especially in the poorest groups. A voucher system that facilitates routine delivery of insecticide treated nets is a feasible option to “keep up” coverage.
机译：>目标：评估坦桑尼亚国家优惠券计划对预防疟疾的杀虫剂处理过的蚊帐对孕妇及其婴儿的覆盖率和公平分配的影响。>设计该研究使用了三个具有全国代表性的横断面家庭和卫生设施调查，该调查的时间定为在国家计划推出之前，中期和结束时进行。>设置在产前服务中实施，并于2004年10月开始逐区逐步实施，并于2006年5月覆盖坦桑尼亚整个大陆。>参与者 6115、6260和6198户家庭（2005年，2006年和2007年，分别代表21个地区的代表样本（总共113个地区）。>干预一张价值2.45美元（1.47英镑，1.74欧元）的代金券，可用于从给每个孕妇开了一家当地商店参加产前服务的女性。>主要结果指标：用杀虫剂处理过的蚊帐的覆盖范围是在调查前一天晚上住户拥有至少一个蚊帐并使用蚊帐。使用基于资产的指数检查了网的社会经济分布。>结果在三年的研究期内，观察到网覆盖率指标稳定增长。在2005年至2007年之间，至少一网（未经处理或经杀虫剂处理）的家庭所有权从44％（2686/6115）增加到65％（4006/6198； P <0.001），并且至少一网经杀虫剂处理的网的所有权增加了一倍从同期的18％（1062/5961）增至36％（2229/6198）（P <0.001）。在1岁以下的婴儿中，任何蚊帐的使用从33％（388/1180）增加到56％（707/1272； P <0.001），而使用杀虫剂处理的蚊帐从16％（188/1180）增加到34％（436/1272； P <0.001）。在对潜在的混杂因素进行调整之后，自计划启动以来，家庭所有权与时间呈正相关，尽管这种关联没有统计学意义（P = 0.09）。每增加一年的计划操作，家庭用杀虫剂处理的净资产增加9个百分点（95％置信区间-1.6到20）。 2005年，只有1岁以下儿童家庭的蚊帐只有7％（78/1115）个是用代金券购买的；该值在2007年增加到50％（608/1211）（P <0.001）。在2007年，最贫穷的五分之一以下的1岁以下婴儿使用经杀虫剂处理过的蚊帐的可能性是最贫穷的五分之一的婴儿的三倍（54％vs 16％； P <0.001）。>结论坦桑尼亚国家优惠券计划在两年内使杀虫剂处理过的蚊帐的覆盖面显着增加。但是，覆盖面仍然存在差距，特别是在最贫穷的群体中。有利于常规递送经杀虫剂处理的蚊帐的凭证系统是“保持”覆盖率的可行选择。

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